Fetal Alcohol-Related Growth Restriction from Birth through Young Adulthood and Moderating Effects of Maternal Prepregnancy Weight
Fetal Alcohol-Related Growth Restriction from Birth through Young Adulthood and Moderating Effects of Maternal Prepregnancy Weight
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DOI：
10.1111/j.1530-0277.2012.01940.x
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发表时间：
2013-03-01
影响因子：
3.2
通讯作者：
Jacobson, Sandra W.
中科院分区：
文献类型：
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作者：
Carter, R. Colin;Jacobson, Joseph L.;Jacobson, Sandra W.
背景：胎儿酒精相关的生长受限持续到婴儿期，但其在晚年生活中的影响不太清楚。动物研究已经证明了母亲营养在胎儿酒精谱系障碍中的重要作用，但产前母亲身体成分的影响尚未在人类中进行研究。这项研究调查了产前酒精暴露对从出生到成年的纵向生长的影响，以及母亲体重和体重指数(BMI)对这些影响的调节程度。方法在首次产前就诊时招募了近480名母亲，其中包括5%的随机抽样的低饮酒者和戒酒者，这些母亲在怀孕期间过度饮酒。在每次产前检查时，他们都会接受采访，了解他们的饮酒情况，并采用时间线追踪的方法。他们的孩子在出生时、6.5个月和13个月，以及7.5岁、14岁和19岁时接受了体重、身高/身高和头围的检查。结果在具有重复测量(调整混杂因素)的多元回归模型中，产前饮酒暴露与体重、身高和身长体重/体重指数的纵向减少相关，这些在出生时基本上是确定的。在低到中等水平的暴露下，这些影响在婴儿期比在儿童后期更严重。相比之下，母亲至少每月饮酒的孩子，以及酗酒和/或依赖女性每次饮酒40次所生的孩子，这种影响仍然存在。此外，孕前体重较低的母亲所生的孩子对体重、身高和头围的影响明显更大。结论这些发现证实了先前的研究表明，与酒精相关的体重、身高、体重/身高比和头围的下降持续到成年。孕前体重较小的母亲所生的孩子受到的影响更大，这可能是因为较小的母亲在一定的酒精摄入量下达到了更高的血液酒精浓度，或者是因为营养较差的母亲所生的婴儿更容易受到伤害。
Background Fetal alcohol-related growth restriction persists through infancy, but its impact later in life is less clear. Animal studies have demonstrated important roles for maternal nutrition in fetal alcohol spectrum disorders, but the impact of prenatal maternal body composition has not been studied in humans. This study examined the effects of prenatal alcohol exposure on longitudinal growth from birth through young adulthood and the degree to which maternal weight and body mass index (BMI) moderate these effects. Methods Nearly 480 mothers were recruited at their first prenatal clinic visit to overrepresent moderate-to-heavy use of alcohol during pregnancy, including a 5% random sample of low-level drinkers and abstainers. They were interviewed at every prenatal visit about their alcohol consumption using a timeline follow-back approach. Their children were examined for weight, length/height, and head circumference at birth, 6.5 and 13months, and 7.5, 14, and 19years. Results In multiple regression models with repeated measures (adjusted for confounders), prenatal alcohol exposure was associated with longitudinal reductions in weight, height, and weight-for-length/BMI that were largely determined at birth. At low-to-moderate levels of exposure, these effects were more severe in infancy than in later childhood. By contrast, effects persisted among children whose mothers drank at least monthly and among those born to women with alcohol abuse and/or dependence who had consumed 4drinks/occasion. In addition, effects on weight, height, and head circumference were markedly stronger among children born to mothers with lower prepregnancy weight. Conclusions These findings confirm prior studies demonstrating alcohol-related reductions in weight, height, weight-for-height/BMI, and head circumference that persist through young adulthood. Stronger effects were seen among children born to mothers with smaller prepregnancy weight, which may have been because of attainment of higher blood alcohol concentrations in smaller mothers for a given amount of alcohol intake or to increased vulnerability in infants born to women with poorer nutrition.